home Analyzes Endometrial norm for conception by days of the monthly cycle. How does the thickness of the endometrium change on different days of the cycle?

Endometrial norm for conception by days of the monthly cycle. How does the thickness of the endometrium change on different days of the cycle?

Content

Many diseases in the field of gynecology are associated with pathology of the uterine body. The inside of the uterine mucosa is lined with cells of a special layer called the endometrium.

The endometrium is the mucous membrane of the uterus, which lines its cavity from the inside and is quite abundantly supplied with blood vessels. The main function of the endometrium is the formation suitable conditions for implantation of a fertilized egg.

The endometrium consists of two layers: functional and basal. The functional layer grows every month during menstrual cycle and is rejected by the uterus at its end under the influence of the complex interaction of the hormones estrogen and progesterone. The rejected layer comes out through the cervix, which is slightly open during menstruation, in the form of bloody discharge. With the beginning of the next cycle, the subsequent growth of a new functional layer of the endometrium begins. The basal layer is not rejected during critical days, but it is precisely thanks to its regenerating properties that the monthly growth of the functional layer of the endometrium occurs.

For the onset of conception and the determination of various pathological conditions, the thickness of the functional endometrium is very indicative. It seems possible to measure its thickness using an ultrasound scan using a vaginal sensor of the pelvic organs.

Thickness of the mucous membrane of the inner layer of the uterus is a non-constant quantity. It changes in women of reproductive age depending on the day of the cycle. During the period before and after menopause, the thickness of the functional layer of the endometrium has different sizes.

The thickness of the functional layer of the endometrium varies depending on the day of the menstrual cycle as follows:

from the fifth to the seventh day of the cycle, the thickness is about five millimeters;
from the eighth to the tenth day of the cycle, the inner layer of the uterus thickens up to 10 millimeters;
from the eleventh to the fourteenth day of the cycle, the mucous membrane can grow up to 14 millimeters;
from the fifteenth to the eighteenth day of the cycle, the thickness varies up to 16 millimeters;
the maximum thickness of up to 18 millimeters is recorded from the nineteenth to the twenty-third day;
from the twenty-fourth day of the menstrual cycle, the thickness of the mucous layer of the uterus decreases.

The thickness of the functional endometrium has its own characteristics in premenopause:

on the days of menstruation, the thickness of the mucous layer is up to four millimeters;
in the initial proliferative stage up to seven millimeters;
in the stage of late proliferation up to eleven millimeters;
in the secretory stage the thickness is up to sixteen millimeters.

In postmenopause, the thickness of the functional endometrium should not exceed eleven millimeters.

Under the influence of various factors and causes, the endometrium undergoes changes that cause its pathological conditions. Among the most common pathologies of the inner layer of the uterine mucosa is endometrial hyperplasia. Endometrial hyperplasia is a pathological thickening of the inner layer of the uterus beyond the established norm. This proliferation is the result of changes that occur in the glands and stroma of the endometrium. Over time, the mucous membrane becomes much thicker than required for its normal functioning.

As a rule, hyperplasia is characteristic of hormonal imbalance and certain concomitant diseases in organism. For example, diseases such as diabetes and hypertension arterial pressure often accompany hyperplasia of the uterine mucosa. Hormonal disorders in combination with other pathologies lead to an increase in the amount of estrogen while a simultaneous decrease in progesterone levels. The result of this improper interaction of hormones is hyperplasia of endometrial tissue.

The thickness of the functional endometrium of the uterine cavity ranges from six to eighteen millimeters in healthy women. With hyperplasia of the mucous layer, its thickness increases to 20 millimeters.

Thickness of the functional endometrium in different types of hyperplasia

It should be noted that the endometrium with hyperplasia can grow unevenly while maintaining healthy areas. In this case they talk about focal form of hyperplasia. It is characterized by the formation of cysts and polyps, which can be visualized using ultrasound. At diffuse hyperplasia The thickened mucosal surface is smooth.

The thickness of the functional endometrium also depends on the type of hyperplasia.

At glandular hyperplasia the mucous membrane thickens with the help of the proliferation of cells that are located in the connective and glandular tissue. There are two forms of the disease: acute and chronic.
Glandular cystic hyperplasia is manifested by blockage of tissue glands, which causes the formation of cysts.
Atypical hyperplasia or adenomatosis is manifested by pathological proliferation of cells with changes in the structure of the nucleus. This phenomenon may indicate the presence of cancer.

Symptoms of thickening of the uterine mucosa

For this pathological condition The mucous membrane of the uterine body is characterized by asymptomatic progression. A woman may suffer from hormonal disorders for years and not know about the presence of endometrial hyperplasia.

Symptoms of hyperplasia usually includes:

abundant bloody issues during menstruation;
infertility;
lack of ovulation;
hormonal imbalance.

The thickness of the functional endometrium is not always indicative. If a woman ovulates regularly and has no problems with conception, then during the study the thickness of the inner layer of the uterine cavity does not play a big role.

Normally, the thickness is allowed to vary up to eighteen millimeters depending on the day of the menstrual cycle. If necessary, it is recommended to measure the thickness of the mucous membrane before ovulation.

Often in gynecological practice there is an absence or disturbance of ovulation and cycle while maintaining the normal thickness of the functional endometrium. Such an inner layer of the uterine cavity may not always be good quality for fertilization.

Women after menopause may experience spotting and even bleeding. In such cases, an examination with mandatory measurement of the thickness of the mucous layer is indicated. In healthy women in this category, the thickness does not exceed five millimeters. If the excess according to the ultrasound results is insignificant, then in the absence of complaints the patient is under the supervision of a doctor and is regularly examined. In the presence of accompanying pathologies, for example, cysts and a significant excess of the normal thickness of the functional endometrium requires a diagnostic curettage procedure.

Diagnostic curettage with hysteroscopy is one of the most valuable methods used in gynecology.

During the procedure, the doctor, using special instruments, performs curettage of the uterine cavity and collects material for further research. The procedure can be used both for diagnosis and as treatment. If curettage of the uterine cavity and cervical canal is required, they talk about performing the so-called separate diagnostic curettage.

The diagnosis of “endometrial hyperplasia” should be made as a result, first of all, of laboratory diagnostics. Thickening and proliferation of the mucosa occurs at the level of cells and tissues, which can be detected during examination under magnification. Based on the results of an ultrasound examination of the pelvic organs using a vaginal sensor alone, it is not enough to identify pathology. There are often cases when the thickness of the mucosa is measured incorrectly. Endometrial hyperplasia is also sometimes accompanied by cysts and polyps, which cannot be carefully examined using equipment. Their benign quality can be judged only after special histological studies.

Endometrial hyperplasia is quite insidious disease. If left untreated, this pathology can cause.

Heavy character of menstruation. Regular blood loss has a negative impact on overall health: it worsens over time general health, anemia develops.
Infertility. The altered endometrium is not able to provide normal nutrition embryo upon implantation. Often the implementation ovum into the walls of the uterus is not at all possible due to the pathological proliferation of the mucous membrane.
Fetal pathologies with developing pregnancy. Cases are not uncommon cancer in a fetus developing with endometrial hyperplasia.
Development cystic formations in the uterine cavity. The endometrium thickens unevenly in the uterine cavity, some areas transform into cysts and polyps of different sizes.
Malignant tumors. Some forms of thickening of the functional endometrium can develop into cancer over time.

Endometrial hyperplasia is often complicated other pathologies of the female genital area. The growth and thickening of tissue leads to various disorders: fibroids, endometriosis, chronic inflammation in the reproductive system.

In order to determine thickening of the mucous membrane, it is necessary, first of all, to undergo regular examination and examination by a gynecologist. Women who are concerned about excessive bleeding, infertility, high blood pressure, or diabetes should be extremely attentive to their health and well-being, and also be examined for the presence of hyperplasia or thickening of the functional layer of the uterus. This pathology can be quite successfully eliminated with adequately selected treatment, including mandatory hormonal therapy. It must be remembered that untreated growth of the mucous membrane over time can degenerate into a malignant tumor.

The endometrium is the mucous layer that lines the uterus. Interior The vagina has an extensive network of capillaries. Women know that depending on the day of the menstrual cycle, the endometrium constantly undergoes changes. The processes occur due to the effect of hormones on the endometrium, which also change from day to day of the cycle. Strong changes occur when a woman is of reproductive age, the body is actively preparing for conception each time and possible pregnancy. But not every representative of the fair sex knows what size of the endometrium is considered normal, how to monitor it, why thickness is important and what is pathology.

Normal endometrial thickness: why monitor it?

Normal endometrial thickness for fertilization is always under the influence of female sex hormones. When the size of the uterine inner layer is normal, the embryo implants well into the walls and pregnancy occurs.

In order for the fetus to attach well, the thickness of the endometrium must meet certain indicators, since for successful conception thickness plays an important role. You can determine the thickness using ultrasound examination and echography.

The normal size depends on the menstrual cycle. If there are any deviations or inconsistencies, pregnancy is impossible. You can restore the size to meet the standards using hormonal therapy.

Based on the functional and basal layer, the internal lining of the uterus is formed. The functional layer dies and is rejected at the very beginning of the menstrual cycle. But before the onset of a new cycle, it has the ability to recover thanks to the regenerative abilities of the basal layer.

Therefore, it is so important for successful attachment and conception to form a normal inner layer. Level female hormones varies depending on the day of the menstrual cycle. The size of the basal layer increases dramatically at the end of the cycle, and after the end it becomes completely thin.

Norm and deviations

How to determine when the uterine endometrium is normal and when there are deviations? The problem can be identified using ultrasound.

For example, if a woman is of reproductive age and has no problems or abnormalities, the normal endometrium should have the following dimensions:

for the first 2 days of the cycle, when the discharge has already begun, the thickness should be in the range of 0.5-0.9 cm - the desquamation stage;
when the regeneration phase begins on days 3-4, the dimensions are within 0.3-0.5 cm;
proliferation on days 5-7, sizes reach 0.6-0.9 cm;
middle phase on days 8-10 thickness 0.8-1.0 cm;
late proliferation sizes from 0.9 to 1.3 cm;
secretion phase, which occurs at the end of the cycle, the size gradually increases, ideal thickness 15-18 days, 1.0-1.6 cm, 19-23 days, 1.0-2.1 cm (varies 10-18 mm), 25 -27 the mucous layer becomes thinner and becomes 1.0-1.8 cm (error 10-17 mm).

In accordance with the standards, it is clear that the condition of the endometrium is constantly changing. For example, if the indicators are higher than the norm, this is not always considered a deviation. As a rule, this happens during a long cycle.

Types: small and large endometrium

Experts often note that the structure of the mucous layer is disrupted. In connection with this, the types of endometrium are distinguished: thin and thick. Therefore, if the size by day of the menstrual cycle exceeds the norm, then this deviation is called hyperplasia. If the endometrium is small, it is hypoplasia.

Why are such deviations from the norm in one direction or another dangerous? With hyperplasia, the mucous layer exceeds the average value of indicators if a rapid increase is observed during a 20-30 day cycle. It can be assumed that the blastula develops on early pregnancy. Growth may also be facilitated by hormonal disorders in particular, an excess of estrogen or a lack of progesterone. Often hyperplasia is combined with fibroids, endometriosis and others inflammatory diseases, therefore, the diagnosis of “hyperplasia” can cause a number of complications associated with fertilization.

If the endometrium is small, the hypoplasia layer becomes thin. For example, the norm is 10-14mm, ultrasonography in the middle of the cycle it shows a result of only 6mm. If the indicators do not correspond to the norm or a heterogeneous structure is detected, this is already a pathology. A small endometrium is considered a significant obstacle to successful conception.

P Reasons that provoke thinning of the mucous layer:

Hormonal imbalances or endocrine system, more often these reasons become a catalyst. Problems can be caused by taking medications that contain hormones, and the impact of psycho-emotional stress is also possible.
Problems with normal blood supply to the uterus, which are congenital or acquired.
Underdevelopment of the organ - the uterus has deviations associated with the design or structure.
Damage to the mucous layer during surgery or manipulation in the organ cavity.
Infections and inflammations.

It has also been proven more than once that a small endometrium can arise at the genetic level. You need to understand that the mucous layer is women Health, so how it grows and functions determines your future chances of pregnancy.

What to do if abnormalities are detected on ultrasound?

Diseases of the endometrium of the uterus and pathologies associated with the mucous layer - common occurrence. Therefore, treatment is required for both “thinned” and “thickened” endometrium.

When diagnosed with hyperplasia, treatment is based on taking hormonal drugs. In neglected and severe cases may be shown surgical treatment– amputation of the mucous layer. In serious situations where the disease has spread far beyond normal limits, it is possible complete removal uterus.

As a rule, more often women need complex treatment, that is, surgery with replacement hormonal therapy for preventive purposes.

With a thinned endometrium, the chances of a complete recovery are not so great. This type of problem is difficult to treat. As a rule, experts prescribe an increase in the dose of estrogen and Aspirin (in a minimal dosage).

Physiotherapeutic procedures are also prescribed additionally. It has also justified itself alternative treatment in the form of hirudotherapy and acupuncture. Therapy with the use of sage is possible, which has also proven itself well.

When a woman crosses the border of perimenopause, a restructuring of her body begins, hormones jump, the mucous surface of the uterus gradually atrophies, leading to the logical conclusion of reproductive abilities.

But, if there is a norm for the endometrium of the uterus during menopause, then deviations from it naturally occur. And they occur quite often...

The endometrium is a mucous layer internal walls uterus. It is formed from two layers, different in structure and function. During hormonal activity, it undergoes a number of modifications, in particular its thickness also changes.

The clinical norm for the superficial mucous membrane of the uterus during menopause is 4-5 mm, but the thickness may vary depending on the phase:

This process is necessary for a woman to be able to conceive a child. The thickness of the inner layer of the uterus must be at least 12 mm to ensure implantation of the fertilized egg.

Every millimeter matters. On average, in the early secretion phase, the thickness that the endometrium reaches is 13 mm. If the endometrium is hypoplastic and thin, the pregnancy may end in miscarriage.

Due to hormonal changes that occur during the cessation of menstruation, the thickness of the internal mucous membrane gradually becomes smaller, as a result of which the woman loses the ability to bear a child.

Physiological hypoplasia is the normal thickness of the endometrium during menopause, it is about 5 mm.

Phases of menopause in women

Menopause is one of the stages of menopause when menstruation stops.

The phases of menopause are:

– the stage of menopause, which covers the period from the first menstrual cycle to the last.
The term is sometimes used incorrectly to describe a condition known as premature menopause.
– refers to those years when hormonal fluctuations begin.
In essence, it combines premenopause and menopause itself. The endometrium undergoes characteristic changes during menopause. Very often, it is during this period that a condition occurs that doctors call “endometrial pathology in menopause.”
– this is the period of complete cessation of menstruation and hormonal changes, which ends at the age of 65-69 years.
At this time, the ovaries can no longer continue to function and menstruation stops completely. Menopause is considered complete when there have been no periods for a year.

In each phase of menopause, the structure of the endometrium changes.

As the cycle progresses, the thickness of the endometrium changes.

Let's look at what it becomes during premenopause:

single-phase and two-phase cycles alternate, which are called anovular;
prolonged exposure to low concentrations of estrogen leads to poor functioning of the mucous membranes, along with elements of moderate glandular hyperplasia, which is called transitional endometrium;
improper distribution of gland functions leads to cystic formations;
the nuclei of the epithelium of the glands have different locations;
stromas have different densities;
increased stimulation of progesterone causes ultramenstrual or secretory endometrial hyperplasia.

Changes in the endometrium in postmenopause are also quite characteristic:

transitional endometrium is the state of the endometrium in the first few years, after the last menstruation;
as a result of the fact that the secretory function of the ovaries is reduced, endometrial atrophy occurs, which is considered physiologically normal for this period;
endometrial functions decrease in postmenopause, which indicates the inability to become pregnant.

What is hyperplasia of the inner layer of the mucosa?

Main endometrial condition female organ and the norm of its thickness during menopause indicates that the woman is healthy, although she has lost her reproductive function.

The thickness of the endometrium of the uterus in menopause should be 5 mm. When the inner layer of the uterus is 6 mm or more, we can already talk about hyperplasia.

Hyperplasia of the inner layer of the uterus during menopause is a change in the structure of its tissues and glands, that is, the growth of the endometrium is characterized by a change in its structure, which is characterized by a heterogeneous endometrium.

A pathological increase in the thickness of the functional layer of the mucous membrane of the uterine cavity can cause. Pathology of the endometrium during menopause indicates hormonal changes, indicating that reproductive function lost.

Endometrial hyperplasia is a pathology.

Unfortunately, endometrial hyperplasia in postmenopause, with a high probability, can degenerate into malignant process. Since during this period the woman’s uterine mucosa is not renewed, the structure of the endometrium also changes. This period is characterized by the fact that the inner layer is loose and the endometrium is heterogeneous.

There are a number of reasons that increase the likelihood of endometrial hyperplasia during menopause:

history of mastopathy or uterine fibroids;
excess adipose tissue;
hypertension;
history of treatment with hormones (estrogens);
carbohydrate metabolism disorders (diabetes mellitus type I and II);
liver pathology.

Expert opinion

Alexandra Yurievna

Doctor general practice, associate professor, teacher of obstetrics, work experience 11 years.

Heredity plays an important role in this, i.e. if close female relatives had a similar disease, there is every chance that the same will happen to you.

Classification of hyperplasias

Depending on which cells begin to enlarge and proliferate, they are distinguished:

According to the type of spread, diffuse and focal forms of the disease are classified. With the first type of hyperplasia, the surface layers of the mucosa grow evenly, and it is characterized by manifestations of diffuse changes.

With focal – different severity is observed structural changes on different areas mucous membrane. What is common is that all types are characterized by a heterogeneous endometrium, diagnosed by ultrasound.

How to diagnose hyperplasia

If a woman goes to the doctor complaining of bleeding and pain during menopause, what does this mean?

To begin with, the doctor must familiarize himself with the patient’s medical history, history of previous diseases, focusing on pathologies reproductive sphere, it is also necessary to find out what kind of treatment she had previously, find out whether there were surgical interventions on the organs of the reproductive system.

To complete the picture, the doctor must ask whether the patient’s mother had similar complaints during menopause.

Before diagnosis and treatment, a woman must undergo a series of diagnostic procedures, because endometrial pathology during menopause is very common.

In this case, the examination should be comprehensive and include examination in a gynecological chair, biochemical and general analysis blood, taking smears for cytology, ultrasound, as well as invasive diagnostic methods, which make it possible to install accurate diagnosis and type of hyperplasia.

Diagnosis must be timely, because with a delay in diagnosis, the risk of malignant degeneration is likely to increase.

To assess the thickness of the mucous membrane of the uterine cavity, a transvaginal ultrasound is performed. If the thickness of the endometrium during menopause is normal, then it is 6 mm, in which case the ultrasound is repeated several more times within 6 months to make sure that there is no growth.

The main signs of hyperplasia on ultrasound:

Uniform tissue thickening, uniform echogenicity and smooth outlines.
Polyps are characterized by increased acoustic density, smooth contours and an echo-negative rim. If the polyps contain oncological changes, their rim has a jagged, scalloped contour. Echographic signs of polyps are local thickening of tissues and the presence in the structure is due to the presence of formations with anechoic inclusions.
In the case when the endometrium in menopause is 8 mm -10 mm, treatment is prescribed and diagnostic curettage. This procedure, along with diagnostic purposes, also has a therapeutic purpose.
The presence of inclusions of increased echogenicity.
It is diagnostically difficult to identify a glandular polyp of the mucous membrane, which has a soft consistency, flattened shape and sound conductivity close to that of inner shell uterus, i.e. it is practically isoechoic.
In case of cancer of the inner layer, the echographic picture is polymorphic, its heterogeneity is also

A biopsy is advisable for diffuse forms of hyperplasia. This method makes it possible to determine the exact thickness of the endometrium, the type of pathological changes in it, and cancer.

How to treat hyperplasia

There are both conservative and radical surgical methods treatment of this pathology:

In some cases, it brings positive results. Women are prescribed pharmacological preparations progesterone series. The duration of treatment with hormones can range from 3 months to 1 year.
Another type of treatment for hyperplasia, when the growth of the endometrium is significant, are methods surgical intervention, namely diagnostic curettage, on the basis of which a more accurate diagnosis is established. In addition, this method is used to stop uterine bleeding.
In case of local processes of hyperplastic growths, the thickened layers of the uterine mucosa are cauterized.
At atypical form development of hyperplasia, with high probability cell degeneration, surgical hysterectomy is prescribed, that is, removal of the uterus.
Currently, more and more people are resorting to combined methods treatment.

During menopause, treatment includes vitamin preparations, immune stimulants that increase the body's resistance. And Special attention pay attention to normalizing lifestyle and giving up bad habits.

Life in menopause is the norm

From all of the above, we can conclude that pathological changes V menopause– a frequent phenomenon, due to the characteristics of changes hormonal levels women. Diagnosis and treatment should be carried out in specialized medical institutions.

Every woman, entering a difficult period of life for her, must realize that her health and well-being are 90% dependent on herself. No one is immune from reproductive problems, but when timely diagnosis and adequate therapeutic measures, this pathology can be preserved high quality woman's life.

So, dear ladies, do not wait for the onset of the disease, but be regularly examined and visit your gynecologist.

Collapse

The endometrium is a hormone-dependent mucous layer lining inner surface uterus, which is renewed during the monthly menstrual cycle and to which the embryo is attached at conception. Since the layer is hormone dependent, it often undergoes changes when hormonal imbalance. Excessively thick endometrium– the most common type of pathology of the uterine mucosa. The material explains why it appears and how to get rid of this phenomenon.

Definition

The phenomenon of thick endometrium is called hyperplasia. What does it mean? This is a disease in which, under the influence of hormonal imbalance, there is an active proliferation of tissues of the mucous layer of the uterus. This happens when there is an excess of estrogen, since it is this hormone that regulates the growth and renewal of the layer in the menstrual cycle. And also, with a lack of progesterone, since it is able to suppress excessive estrogen activity.

In what cases can we say that an overly large endometrium has developed? This layer changes its thickness throughout the menstrual cycle. However, normally its thickness can vary from 5 mm to 15 mm.

The most serious deviation is a thick endometrium at the beginning of the cycle, since during this period it should reach a minimum thickness. And its thickening can lead to unpleasant and even severe symptoms.

Why does thickening occur?

As mentioned above, the causes of thickening lie in hormonal imbalance, which develops as a result of stress, unhealthy lifestyle, non-compliance with work and rest schedules, lack of sleep, sudden weight gain or loss. Often this phenomenon can develop when endocrine diseases or ovarian hyperfunction.

A characteristic feature is that this disease develops exclusively in women reproductive age. Since in the post-reproductive phase the ovaries stop working altogether, and the endometrium decreases significantly. Thus, it cannot increase, since estrogen is completely or almost completely absent in the body.

Consequences

Hyperplasia can negatively affect the likelihood of conception, since the fertilized egg cannot attach to such endometrium. But even if this happens, there is a high risk of miscarriage as a result of embryo rejection when the pathological endometrium is renewed. Although sometimes it is still possible to carry a pregnancy to term. In this case, the place is complicated birth process accompanied by significant bleeding.

Symptoms

Thickening of the endometrium in the uterus can lead to quite severe symptoms. The following clinical picture is formed:

Increased volume of menstrual bleeding;
Lengthening menstruation;
Reducing the period between them;
Acyclic bleeding of varying intensity;
Pain in the lower abdomen, worsening on the eve of menstruation;
Sometimes pain and discomfort may occur during sexual intercourse.

The condition is not specific and may indicate many other diseases. For this reason differential diagnosis may cause difficulties for the doctor initial stage its implementation.

Diagnostics

The condition is diagnosed taking into account the history and symptoms, but the greatest role in diagnosis is given to instrumental studies. Are being done the following types manipulations:

Ultrasound examination of the uterus;
Diagnostic endometrial scraping;
Diagnostic hysteroscopy;
Blood test for hormones;
Colposcopy.

In some cases, other research methods may be prescribed.

Treatment

Hyperplasia is treated mainly with hormonal drugs. However, if the lesion is focal in nature, that is, localized in several small, clearly defined areas, then coagulation can be used.

Coagulation

This is a method of cauterizing foci of growth in one way or another, as a result of which they stop growing. What cauterization methods are used?

Electrocoagulation - cauterization electric shock– the oldest and most traumatic method;
Cryodestruction - cauterization with liquid nitrogen - is the most preferred method among those that are widely used;
Laser treatment and radiosurgical methods are rarely used and expensive, but effective and safe methods low morbidity.

Cauterization is performed during hysteroscopy. With such an intervention, a hysteroscope apparatus equipped optical system, is introduced into the uterine cavity through cervical canal. With its help, miniature surgical instruments, and cauterization is performed.

The use of this method should be combined with the use of hormonal drugs. Since in their absence, the uterine mucosa may become thicker than it should be, again, new lesions may appear.

Scraping

For both focal and common hyperplasia, the method of curettage of pathological endometrium can be widely used. During it, using a special loop or curette, mechanical removal foci of mucosal proliferation. This is also done by hysteroscopy. This method is quite traumatic, especially in large areas, therefore it is prescribed only when hormonal treatment did not help. It should also be carried out exclusively in combination with hormonal therapy, since otherwise the problem may arise again.

Drug treatment

If thickening of the endometrium of the uterus is observed over the entire area of the mucous membrane, then we can talk about total hyperplasia. Doctors prefer to treat this condition with hormonal drugs, as the method is the safest. Depending on the nature of hormonal imbalances in a woman’s body, certain medications can be used:

Combined oral contraceptives that help normalize hormonal balance, align menstrual cycle, therefore, make the renewal of the endometrium more cyclical. These are products such as Yarina, Janine, Regulon, Marvelon. They are taken for 3-4 months, with each new package starting from the first day of the menstrual cycle. These drugs contain estrogen and progesterone;
Progesterone medications help because this hormone is able to suppress excessive estrogen activity without directly reducing its levels. These are products such as Duphaston, Utrozhestan. They are used for 3-4 months and help normalize the condition of the mucous membrane and the frequency of its renewal during this time;
Gonadotropin-releasing hormone agonists are drugs such as Buserelin, Zoladex. Their regular use for 4-6 months helps to form the condition artificial menopause, during which the thick layer of the endometrium degrades. After stopping the drugs, the menstrual cycle returns to normal. This method is rarely used and only in cases where the rest medications ineffective.

An enlarged basal layer of the endometrium may cause serious consequences And unpleasant symptoms, therefore it must be treated promptly. If you notice symptoms of this phenomenon, a woman should immediately consult a doctor.

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The endometrium is a mucous membrane that lines the inside of the uterine cavity and has a well-developed network of blood vessels. The endometrium creates conditions favorable for the development of the fertilized egg. In addition, he is assigned one of critical roles in the mechanism of the menstrual cycle.
The endometrium consists of two layers - basal and functional. During menstruation, it is the functional layer that is rejected, which, thanks to the basal layer, is restored in the next cycle. The thickness and structure of the endometrium are completely subordinated hormonal influence. In the second phase monthly cycle this mucous layer grows, its blood supply increases significantly. The uterine cavity is preparing for possible implantation fertilized egg. If pregnancy does not occur, the endometrium rejects functional layer, menstrual bleeding occurs.

During an ultrasound, the thickness of the endometrium can be determined. This indicator is especially important for those who are planning a pregnancy. The thickness of the endometrium varies depending on the day of the menstrual cycle:
On days 5-7 of the cycle (phase early proliferation) the average thickness of the endometrium is 5 mm (range 3 mm to 6 mm).
By the 8-10th day of the cycle (medium proliferation phase), a gradual thickening of the layer is observed - from 5 to 10 mm (on average - 8 mm).
On days 11-14 of the cycle, late proliferation is observed, and the thickness of the endometrium reaches 7-14 mm.
The early secretion phase (15-18 days of the monthly cycle) is characterized by an endometrial thickness of 10-16 mm (average value - 11 mm).
The period of average secretion (19-23 days) is accompanied by maximum thickening of the endometrium, its average thickness is 14 mm, and ranges from 10 to 18 mm.
On days 24-27, the endometrium begins to thin, its average thickness is 12 mm.

Structural abnormalities of the endometrium can be characterized as thinning (hypoplasia) or thickening (hyperplasia) of the endometrium.

Endometrial hyperplasia:

Endometrial hyperplasia is accompanied by changes in the stroma and glands that make up the mucous membrane. In this case, the thickness of the endometrium is sharply increased, the mucous layer grows, which leads to a hyperplastic process.
Endometrial hyperplasia is caused by hormonal pathology, which is characterized by an excess of estrogen and a lack of progesterone. Most often women with diabetes mellitus and other metabolic disorders, as well as patients with arterial hypertension.
In most cases, endometrial hyperplasia is not accompanied by any symptoms, but there are dysfunctional uterine bleeding, anovulation. The hyperplastic process is often detected as a finding during examination for infertility.

Endometrial hyperplasia causes infertility for two reasons:
- lack of ovulation due to hormonal pathology;
- absence favorable conditions for embryo implantation.

Drug treatment endometrial hyperplasia requires the prescription of hormonal drugs. Also applies surgery, which consists in removing the overgrown mucous layer. Severe, serious cases require removal of the uterus. Good results gives combination treatment: removal of thickened endometrium with further transfer to low-dose hormonal therapy.

Endometrial hypoplasia (“thin” endometrium):

Due to some gynecological diseases, the endometrium may remain thin throughout the entire monthly cycle. “Thin” endometrium occurs when chronic endometritis, pathologies of estrogen receptors in the endometrium, impaired blood supply to the internal uterine layer.
During ultrasound monitoring, the doctor has the opportunity to assess the thickness and structure of the endometrium and identify the problem of “thin” endometrium. Endometrial hypoplasia is difficult to treat effective therapy, and most often is temporary. Drug treatment involves the use of drugs with high doses estrogens and low doses of aspirin. The endometrium responds well to the use of physiotherapy, acupuncture, treatment medical leeches. Sage also stimulates endometrial growth.
Remember, any endometrial pathology requires a competent approach to treatment, and this is only possible after identifying the specific causes of the disease.